Primary Doctors: Primary doctors are generalists who are trained to be the first line of defense for common health complaints.  Because there is such a shortage of psychiatrist primary doctors have taken on more responsibilities such as prescribing medications for mental disorders.  The strains on our health care system mean that many PCP’s are under pressure to treat conditions themselves rather than refer to a specialist.  Yet, patients should carefully consider if their PCP is the best person for their needs.  Because many common symptoms can overlap different root causes, achieving the best results to psychiatric medication is often the matter of being under the care of a specialist who is very skilled at differential diagnosis. For example, a patient may present with anxiety when the root cause of the anxiety is an inability to sustain attention and focus.  When a skilled practitioner can assess for ADHD symptoms and treat this first often anxiety disappears.  The profit margins of large health care complexes putting pressure on doctors to treat all conditions should be of less import than patients feeling empowered to see the right kind of provider.   If a patient had a heart problem they would insist on seeing a cardiologist, a specialist who is an expert for that specific needs.  

Psychiatrist: Psychiatrists are medical doctors who specialize in diagnosing and treating mental illnesses. Their training pathway requires a medical degree followed by a four-year residency in psychiatry.  Because the breadth of information needed in medical school is so extensive and well beyond the scope of just psychiatry, a complaint about traditional medical training is that the humanistic aspects of training doctors does not receive adequate attention. Doctors, including psychiatrists, can have limited training on how to develop a good bedside manner or rapport with patients.    

Psychiatrists are widely trained to approach mental health from a medical model, which emphasizes the biological and chemical aspects of mental illness. While attempts at changing medical curriculum are slowly changing (see this link for more).   Psychiatrists rely heavily on psychopharmacology, the study of how drugs affect mood, behavior, and mental processes. Mainstream psychiatry is less apt to consider the patient’s other health factors such as environment, social support system, diet and exercise  and food as medicine.   In other words, the medical model can overlook important aspects of their mental health, such as life circumstances, personal history, and social factors.

 Yet, psychiatry has an important place in patient care. For some treatment-resistant presentations, psychiatrists are also the only mental health professionals who can perform medical procedures such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS), which are often used for patients who do not respond to standard treatments. However, seeing a psychiatrist comes with a downside; psychiatrists are in high demand, and the shortage of these professionals means that patients may face long wait times to get an appointment. This can be particularly challenging for those in need of immediate care or those living in areas with few mental health resources.

Psychiatric Nurse Practitioner: Psychiatric nurse practitioners are advanced practice registered nurses who specialize in mental health care. They typically hold a master’s or doctoral degree in nursing with a focus on psychiatry, and their training includes both nursing and psychiatric education. PNP’s are qualified to diagnose and treat a wide range of mental health conditions. They can also prescribe medications, provide psychotherapy, and manage patient care, often working autonomously or in collaboration with other healthcare providers.

One of the significant advantages of seeing a PNP is their holistic approach to care. PNPs are trained to consider the physical, emotional, and social aspects of a patient’s well-being, which can lead to a more comprehensive treatment plan. PNP’s often work collaboratively with therapists and share a wider overlap sensibilities than sometimes occurs with psychiatrists.  

When developing a personalized treatment plan, psychiatric nurse practitioners  take a holistic approach to mental health care, emphasizing the connection between mind and body. They are trained to consider the whole person, including lifestyle factors, social influences, and physical health.  As a profession, nursing teaches nurses how to consider bedside manner and the experience of being a patient from the patient’s point of view. 

 In addition to being qualified to prescribe medications,  PNP’s are also more extensively trained to focus on the therapeutic relationships and patient which even outside of mental health treatment is clinically proven to improve patient outcomes (Ward 2018)..  PNP’s also have more skills and training to focus on patient education (which again focuses on better patient outcomes) and  which can lead to a more personalized and collaborative treatment experience. 

For instance, a PNP might spend more time discussing coping strategies, stress management, and self-care techniques with patient.  This can create a more supportive environment for patients who prefer a less clinical and more interactive approach to their mental health care.